The events of the Grudge 3 occur several months after the Chicago vignette of The Grudge 2 . Jake Kimble is now institutionalized after the gruesome murder of his family. His caretaker is Dr. Sullivan, who is skeptical of Jake's stories describing a woman with long black hair covered in blood as the murderer. Eventually she becomes aware of the truth when Jake is killed by the curse.Naoko Kawamata,a young Japanese woman,hears of Jake's death and becomes worried. Naoko is the sister of Kayako and knows how to stop the curse. She travels to Jake's former home, the Chicago apartment building, to attempt an exorcism in order to end the curse.

The inhabitants of the building include Gretchen, an elderly woman who paints, and Lisa, Rose, and Max, a family living below the Kimble's apartment. Max is the landlord of the building and has to pay medical bills, for his sister Rose,who has a severe breathing problem. After Lisa becomes aware of the deadly curse she seeks Naoko's help.